closed-loop insulin delivery in children
TRANSCRIPT
Closed-Loop Insulin Delivery in Children <7 Years of Age
Closed-Loop Insulin Therapy (CLT)
Background
• Children at increased risk of hypoglycemia, especially at night
• Neurocognitive effects can result
• Children have unpredictable eating patterns and erratic activity levels
• by insulin pump
Closed-Loop Insulin Delivery in Children <7 Years of Age
Objective
•The aim of CLT is to achieve tight glucose control and reduce risk of hypoglycemia
•CLT combines glucose sensing and insulin-delivery components with real-time glucose-responsive insulin administration
- Disposable sensor measures interstitial glucose levels- Algorithm controls rapid-acting insulin analog delivery
•The aim of this study as to test CLT in young children with diabetes
Closed-Loop Insulin Delivery in Children <7 Years of Age
• Children <7 years with T1DM >6 months treated with insulin pump therapy for >6 weeks (n=10)
• Randomized crosss-over trial comparing CLT with open-loop therapy
• Two control periods: overnight and daytime
• Target blood glucose: 10 PM-6 AM – 150 mg/dL; 6 AM-noon – 120 mg/dL
Design and Methods
Closed-Loop Insulin Delivery in Children <7 Years of Age
Study Design
Closed-Loop Insulin Delivery in Children <7 Years of Age
Results
• Time at night target increased with CLT but not significantly different from open-loop
• Time in overnight extreme hyperglycemia and total glycemic excursion significantly reduced
• No difference in number of interventions for hypoglycemia
Closed-Loop Insulin Delivery in Children <7 Years of Age
Closed-Loop Insulin Delivery in Children <7 Years of Age
Conclusions
• CLT decreased the degree of noturnal hyperglycemia in young children without increasing the incidence of hypoglycemia
• CLT improved prelunch blood glucose
• CLT has the potential to improve diabetes care in very young children